The Pain of House

Hugh Laurie as Dr. House, a white man posed as a Caduceus with wings and two large snakes wrapped around his body on a blue field. Caption reads "Incurably Himself".

I am a pop-culture junkie. If you have been playing along at home long enough this is common knowledge. I have been a big fan of House, M.D. since it’s poorly lit pilot. I am simultaneously appalled and amused by his crass behavior. Even the best feminist in me laughs and fairly inappropriate moments.

I have seen and read plenty of critques concerning Dr. House and his manner. I have chewed out my share of doctors for acting like him as if it makes them seem clever. He is a character that is worth critiquing on many levels and for many reasons from many points of view.

What I haven’t seen is a lot of criticism of the characters assembled around House. From Dr. Wilson, or Dr. Cuddy, or the myriad staff members he has had around him (yes, even Dr. Cameron-Chase) I have watched for nigh on five seasons now as all of the people who claim to care about him have done little more than chastise and concern troll his life. Most notably, his addiction to Vicodin as his chosen method of pain management.

A repeated theme throughout the series has been watching person after person in House’s life try to trick or otherwise convince him that he should quit taking Vicodin and learn how to deal with his pain. They constantly badger him about his addiction, and will go to great lengths to get him to quit taking his pain medication.

Only a person who has never experienced chronic pain would dare criticize a person for their pain management.

Because, like it or not, Dr. Gregory House is managing his pain. Sure, he is an addict. There is little argument there. The character admits it freely. In his own words he says that he takes a lot of pills because he is in a lot of pain. Whatever your feelings on narcotic medication it is a proven method for making intense and chronic pain manageable, and a down side to that is that narcotic drugs can in fact be dependency and/or addiction forming. The presence of an addiction does not take away the fact that the pain beneath it is real. When a doctor and a patient together decide to pursue pain management via narcotics such as Vicodin they will weigh the pros and cons of such treatment. One of the cons that is weighed is the fact that a person can develop an addiction to a drug and a tolerance that will probably mean their intake will increase over time. As with any course of treatment the costs must be weighed with the benefits.

Photo: Hugh Laurie as Dr. House, a white man in a presumably porcelain bathtub filled with orange prescription bottles, dressed in a grey suit with his cane.

House is able to function as a result of the Vicodin to which he has become addicted. He is able to be independent in moving and living, not housebound (no pun intended) by his pain. He is able to hold down his job and do it with the skill through which he receives his notoriety. His course of pain management gives him a life and independance that many of us living with pain or other disabilities are hoping to achieve. It might not make him a happy ray of sunshine all the time, but neither does living in agonizing pain all of the time.

It is very condescending for a person who is not living in pain to assume that they know better than that person how to manager hir pain. The way that I see House’s collegues and the people who could pass for his friends treat him over his addiction and the way he manages his pain strikes too close to the way I feel most doctors and friends of those of us living in chronic pain will treat us.

Criticize the way he behaves to his subordinates. Criticize the way he treats those closest to him. But if you don’t know what it is like to live with chronic pain, don’t criticize his decisions as to how he manages his pain. If it’s not your body, frankly, it’s not your business.

About Ouyang Dan

is an extremely proggy-liberal, formerly single mommy, Native American, invisibly disabled, U.S. Navy Veteran, social justice activist and aspiring freelance writer currently living in South Korea on Uncle Sam's dime. She has a super human tolerance for caffeine and chocolate and believes she should use those powers for good. She said should.
She is not a concise person, and sometimes comes on a little aggressively in comments. Sometimes her right arm still twitches when military brass walks past her, but she would rather be reading YA Lit or pwning n00bs.
She can be found being cliche about music, overthinking pop culture, and grumbling about whatever else suits her fancy at her personal website, random babble.... She also writes about military issues for Change.org's Women's Rights blog.
If you have something interesting to say email her at ouyangdan [at] disabledfeminists [dot] com. Lawyers in Italy looking to hold lottery winnings in her bank account may wait longer for reply.
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42 thoughts on “The Pain of House”

Apparently all of us who live with chronic pain should have the goal of managing it without narcotics. Just like everyone with mental illness should be striving to manage their conditions without psychiatric meds. It’s all too common an attitude, and it’s extremely destructive.

I’ve been very confused with this season of House. He’s off the Vicodin, I think they said that he’s just using Tylenol, and his pain seems no worse than it was when he was on the Vicodin. It even seems a bit better. Which makes no sense. I really expected this season to deal with him accepting that his choices are pain or addiction, and addiction leads to all the badness that happened at the end of last season, and him having to actually make decisions about that. Instead, we’re getting that he can just distract himself from his pain, and he’s leaning on his cane much less than in previous seasons. The writers have also been really inconsistent about whether his limp is caused by pain or muscle damage or some of both.

Ruchama, I’ve noticed that too. It seems like what they are telling us is that his pain is all in his head (a theme that’s come up in past episodes too), which would seem to imply, by extension, that people with chronic pain just need to distract themselves/try a little harder and then they will not be in pain. Which is a pretty toxic message that society is already broadcasting loud and clear.
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I have watched a few House marathons on USA, and I loved the show except for House himself (the show would be great if they got rid of him and the chief-lady, Cuddy? She, [line redacted for anti-feminist language, please refer to the Comments Policy], got to me). Since I was just watching random episodes, I never thought much about his pain or what it was like for him to live with that (my TAB privilege also helped me conveniently ignore that aspect of his character).

Does the show accurately depict how someone addicted to painkillers (because of chronic pain, such as House’s) functions? I am ignorant on this subject, and as someone on the outside and very ignorant (but with a mother who works with people with chemical dependencies, who is very sensitive to addiction because she’s seen how ugly it can be), I am asking to find out, not to dismiss or attack.

House is rude and cranky, but he has control over his addiction. He can perform his job duties (and when he doesn’t it’s because he actively chooses not to); he doesn’t seem to have any of the negative side effects one usually associates with “drug addiction.” Maybe I haven’t seen the episodes that address that since I’ve only seen a handful of episodes, but from the little I’ve seen of the show, while I agree that he is “addicted” because he takes lots of pills and he depends on them, I wouldn’t call him an “addict” because he is not “out of control.” (My point being, since I feel I am being very unclear, is that if he can handle the “addiction,” where’s the problem? Yes, I get that he does illegal things to get his prescriptions, but that’s a problem with the law being narrow-minded and limited, if he really needs that amount of medication and suffers no side effects.)

Given what you have written in the comments about this season of House, I wonder how much the writers of the show actually know about chronic pain and addiction to painkillers. Or if the original writers are no longer there, and they now have a new batch that does not understand these issues as well as they should (if they’re going to be writing about it), and that’s why the show seems to be taking this new, and toxic, turn.

I love this post! Exactly! Thank you very much. House is the only mainstream character I can think of who has my disability. And this is the way they portray him, as if his disease management, not his disease, is the problem.

There have been some periods when House’s addiction has been “out of control.” Most of them where when he’s been off the Vicodin for a little while and then was able to take it again and took way too much. There have also definitely been scenes where it seemed like he was taking it to get high more than he was taking it to control the pain. I don’t really know enough about addiction to know how accurate the portrayal is.

During the various times that he’s tried different treatments, there have been some episodes where it seemed like his limp was entirely because of his pain — temporarily relieve the pain, and he can jog a few miles — and others where it seemed like he used the cane to avoid putting weight on his right leg because it would be painful, but his limp was caused by the damaged muscle — temporarily relieve the pain, and he can put weight on that leg without flinching, and doesn’t need his cane, but he still can’t move and bend his right leg the same way he can his left.

*Disclaimer* I have not seen this season of House, M.D. yet b/c of where I am living. I haven’t found a good place for streaming yet.

Some of the points you made can be summed up w/ “this is what happens when you use able bodied people to play people w/ disabilities, IMNSHO”. Hugh Laurie is a great actor, but perhaps he isn’t prioritizing making a painful walk look realistic, I don’t know. Also, IIRC, he uses the cane incorrectly for his particular leg problem, but I could be way off here (and new to cane usage myself), but I remember the episode where his cane use hurt his shoulder and the physio nurse was lecturing him. It could be any of those things.

His portrayal of addiction is exactly what I am wanting to address, because a good chunk of society can’t handle that narcotics are in fact pain management, and not “ignoring the problem” or “giving up”. Personally I think the writers sensationalize the downsides of his addiction without bothering to show the good. It feels like they are trying to make it look bad, which fits right in w/ all the concern trolling the other characters do. I don’t feel the writers have any clue what a person dealing with chronic pain lives with. The whole show is a big judgment that really gets my hackles up (why do I watch it?). I did however think that they were trying to show that he had to choose pain or addiction, which can be something that some chronic pain patients have to live with. Like I have mentioned before it is a cost/benefit game, and doesn’t really have a zero sum. People on narcotic pain meds know that the possibility for addiction exists, despite what a good chunk of the public at large seems to think. If the show is indeed now showing him as managing his pain w/ a few Tylenol, then I think it is losing some of its remaining artistic integrity in my opinion (whatever that’s worth).

I don’t watch House, (goodness knows why). The TV show where I saw this “Woah! Painkillers are bad!” was Celebrity Rehab with Dr. Drew. And the reactions to/treatment of Jeff Conaway was just…a whole lotta Not Right. (Conaway has chronic pain, and was on the show for rehab from cocaine and painkillers). Dr. Drew and the counselors didn’t seem to think that he, you know, needed painkillers. So they set him up with physical therapy and yoga (instead of the painkillers–not in addition to them). The whole thing was just…ugh.
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the ep where the physio nurse was lecturing him was super funny. he is, in fact, using his cane wrong– you become basically tripedal, with the two weak legs (your bad leg and the cane) as the two outside legs and you use them together. it seems like it would make more sense to use it on the same side as the bad leg, but in fact it causes serious back pain such as the serious back pain that hugh laurie actually now suffers due to so many hours of using the cane wrong. i was glad to see them acknowledge that they were screwing it up, but sad to see that they then didn’t take the opportunity to fix it.

i haven’t watched any of this season so i am unable to comment on it but if he’s now on tylenol only, i will definitely need to kick things.
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Yes! I don’t follow House much, just watch the DVDs every now and then, but this aspect of the show has always bothered me.

Apparently all of us who live with chronic pain should have the goal of managing it without narcotics. Just like everyone with mental illness should be striving to manage their conditions without psychiatric meds.

Alternately there’s a “medication will solve everything” mindset. As in, you’re mentally ill? Just take meds (never mind the compatibility, cost, side effects, time to adjust) and don’t bother me about it! Also, don’t talk about your meds or take them when I’m around or in any way impinge upon my image of you as a perfectly normal person who is just like everybody else.

I’m guessing that Dr. House is also problematic because he’s out there popping Vicodin in front of everybody, not hiding his pain. His condition is a part of everybody’s life—just like our conditions affect the people around us—and he makes no bones about it. But this is wild hypothesizing so, fellow commenters, tell me if this interpretation is totally off!
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I’d say you’re not wrong, Tlönista. Both attitudes are out there, and advertising of prescription meds doesn’t help the idea that pharmacology will fix everything.

And I think part of the problem with House is that the writers — like a lot of people without personal experience in pain management — keep confusing dependence with addiction. While they do show House occasionally exhibiting drug-seeking behaviors, most of the time he just seems to be dependent on hydrocodone. Of course, fuck knows what they’re doing this season if his pain is controllable with acetaminophen now.

Very good points. “House” has probably caused further public misconceptions about pain management, unfortunately.

Plus, the show is extremely ableist in many other ways:

-In a first season episode which explains House’s leg injury, it was suggested that House chose not to have an amputation even though that could have eased his pain considerably. So that’s a key point to me: House–supposedly Mr. Rationality–is so ableist that he’d rather be in pain constantly than be an amputee. I find the presentation of this rather distressing.

-The show consistently portrays PWD only in the context of House discovering miraculous “cures” for them. Examples include the teenage girl whose mother was a little person who turned out not to be a little person herself, the jazz musician who didn’t really have ALS, the young man with epilepsy and other brain differences who was miraculously “cured,” the woman who wasn’t schizophrenic, but rather had a curable medical condition. And there are more examples. While on the one hand this may point out the disparities in health care which disabled-labeled people experience, the many repetitions of this plotline feel quite ableist to me–House gets to be the miraculous doctor who makes PWD “normal,” which we all know is what PWD want. Because the only way in which disabled people can be represented is if we’re made all better by the end. Urgh.

-Last season’s episode featuring a Deaf patient was particularly ableist. Deaf culture was misrepresented and mocked as not a “real” culture. There was a ridiculous cochlear implant storyline which–in addition to being completely unrealistic–suggested that House was right to give a Deaf teenager a cochlear implant against his explicit wishes. Just so, so wrong in so many ways.

-This season’s first episode, which legitimized the system of psychiatric institutionalization and psychiatrists’ power ploys over those they classify as “crazy” and “ill.” This was completely sickening to me, and the final straw for the show. I’m not going to subject myself to this ableist tripe any more.

Sorry that this isn’t entirely on-topic. I just wanted to rant about how ableist House (as a show and character) is.
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he is, in fact, using his cane wrong– you become basically tripedal, with the two weak legs (your bad leg and the cane) as the two outside legs and you use them together.

That’s what I thought, but I am no expert, and wasn’t sure that it wasn’t just my specific issue (hip pain, to name one) that required cane use in that manner. I didn’t want to presume to be all knowing after two weeks of cane use. LOL. Thanks, betsyl!

Alternately there’s a “medication will solve everything” mindset. As in, you’re mentally ill? Just take meds (never mind the compatibility, cost, side effects, time to adjust) and don’t bother me about it! Also, don’t talk about your meds or take them when I’m around or in any way impinge upon my image of you as a perfectly normal person who is just like everybody else.

I am guessing you mean “instead of talking to family/friends about it”? And not in the “Big Pharma is bad, mmm’kay” way, right (which is a hot-button of mine, so we will go w/ the former, b/c I think that is what you meant)? I think that might be part of it. I mean, that sparked the whole beginning of the Detective whatsisname story arch, right? That House was so comfy poppin pills that he would do it in front of people? “Normal” people don’t want to be faced with disabilities or anything that helps them. Good Cripples should sit in the back and not draw attention to themselves.

I should be clear. I am not saying that the character isn’t problematic in his narcotic usage. There are certainly criticisms to be made, for sure…I just don’t agree w/ the transparent ones that the writers choose to pursue. Some they use to be funny (he uses Vicodin in front of his patients and brags about how he bets they want some too), but they showcase this dependency as if it is a bad thing…and that makes me uncomfortable.

I can’t say as I pay much attention to TV, and House escaped my full focus when I saw he used that cane wrong… did not spend hours a week in PT, swimming, ROM, extension, and massage. You know the drill.

But, yeah, the portrayal of pain and pain vs medication is a total social fantasy that the medical standards are playing to in RL. Can’t tell you how many “pain specialists” accused me of addiction to a low level of oxicotin over a period of three years- always managed and w/i the “contractual” dosage and limits. Low-level because I worked my ass off at the PT side of pain maintenance. Punished for success, as it were.

I finally gave up, my psyche was being mangled by the medical care givers – not the drugs. Now I am unable to work because of pain, but I don’t have to deal with the people telling me I am bad for trying to cope and having a normal productive life around what shows up on X-Rays and nerve conduction studies.

I think it’s tricky to extrapolate from one extreme character such as House to say “all chronic pain patients should live without narcotics” – House isn’t just some addict, he’s a genius doctor who had an abrasive personality before his infarction.

I really appreciate your insight into the enablers around him, though, and their understanding/lack of understanding for his addiction. In season 2, when they were briefly able to remove House’s pain by putting him into a coma, it came back and it was never clear whether he really was refusing to adapt to feeling his age or the pain was psychosomatic or just the treatment wore off. Dependency vs. management is a complex issue, and I think one of the things that speaks well for House is that he is a larger-than-life character, while several of the guest-starring-patients did have more “standard”/realistic interactions with drugs.

I was wondering if you folks were going to touch on addiction/ alcoholism over here at all! I don’t know if you’d regard someone with an addiction/allergy to alcohol as disabled per se, but it certainly does make for a different reality than what those (i.e. feminists/women) without addictive personalities experience, even for feminists in recovery…Maybe that’s a blog I should start 😛

Does the show accurately depict how someone addicted to painkillers (because of chronic pain, such as House’s) functions?

I don’t know. It’s not a monolith, really. People react differently, as bodies are all different. There is also a difference, as Kaninchenzero mentioned, between dependency and addiction, that the writers are confusing, and they often conflate the two. I also feel like they sensationalize his drug-seeking, but it is a drama, and maybe someone w/ House’s personality really would exploit a friend by stealing his prescription pad. It may or may not be entirely drug related.

House is rude and cranky, but he has control over his addiction. He can perform his job duties (and when he doesn’t it’s because he actively chooses not to); he doesn’t seem to have any of the negative side effects one usually associates with “drug addiction.”

Here is where you and I are going to run into big differences. House does NOT have control over his addiction unless he were to quit taking the Vicodin (and since I have not seen the recent season, we will go w/ what I know), and I don’t view living with intense pain all of the time as a valid choice to ask of someone. The Vicodin allows him to do his job, because it takes care of most of his pain. It helps him to be independent and mobile (we have seen snippets of his mobility throughout the years). We don’t fully know if he could be free from it completely because the show always focuses on his addiction, but they do show that he is fighting the pain while he detoxes. I don’t believe that House could work with that much pain, he gets distracted by it. Not all addicts fit neatly into the box of the out of control junkie you might picture from the experiences your mother has (and now that I think of it, he does more outrageous things to handle the pain without the Vicodin, like smashing his hand with a pestle or cutting). Not all addicts are spiraling into self destruction, and many are high functioning (I’ve known alcoholics who were very well off and had high profile jobs and harmed no one, but spent the hours home from work completely drunk and happy, only to go to work the next day and do their jobs well again). He manages his addiction pretty well as long as his colleagues stay out of it, and is aware of his depencency. He does, also, experience side effects. One episode he couldn’t urinate at all, although am not ready to say that the Vicodin was the sole cause of his hallucinations (again, I think they are totally going full out “drugs are bad, mmm’kay” here).

I love “House,” too, although I am frequently appalled by the show’s treatment of medical ethics — most often, they’re shown as annoying, pointless barriers between House and his Miracle Cure o’ the Week, which annoys me because of the implication that you don’t have to follow any rules if you’re smart enough.

I’ve also noticed the ableism Sarah mentions upthread. The Deaf episode in particular had me sitting there slackjawed.

And I never know what on Earth’s going on with House’s leg. That seems to be fairly common in fictional portrayals of disability: the disabled character’s impairment worsens and improves as the dramatic tension in a story arc goes up and down. Disability as plot device.
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OK, I may have misinterpreted some of what you said Criss, because as I read this again, I think you and I actually agreed on the “control” point. I think maybe what you were saying is that he has control of his life while addicted to pain medication, which is what I was trying to say, and I was both misunderstanding you and not making my point clear in a moment of Fog. Apologies. Also, if it sounded like I was implying that a person dealing with addiction has no control, apologies again, because that is a more nuanced discussion than I was having…I was simply saying that if the choice is Pain or Addiction, there is no control there.

He’s off the Vicodin, I think they said that he’s just using Tylenol, and his pain seems no worse than it was when he was on the Vicodin.

I’ve never seen this show. But pretty much the entire reason it’s medically undsound to prescribe more than a certain amount of Vicodin is because of the Tylenol in it. That may not be why the DEA has it as a schedule 2, but large amounts of acetaminophen are inarguably hepatotoxic. I have to wonder if that’s where they’re going with this, that he’ll mulch his liver from all the Tylenol.

I just reviewed the clips I’ve been saving to post about House myself (the gratuitous use of “lame” as a generic slur, without a trace of hipster irony). He’s on ibuprofen, not acetaminophen/paracetamol.
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House, the show and the character, is definitely very problematic.
One of the things I saw in the various story lines about his use of Vicodin is that they are constantly hinting at psycho-somatic aspects of his pain. Like, he is upset about his ex returning, and then he is suddenly in more pain, which he deals with by taking more vicodin.

The thing is, I know that pain can be caused by psychological issues. I know that when I had a ruptured disk, my pain got a lot worse when I was stressed out, because I would get tense and this made the pain worse. I also stopped catching every bug that was around, as I used to, and instead my back and leg would hurt when I was exausted and my body was forcing me to take a break that I really needed.

So I am not saying that addressing this possibility is neccessarily a bad idea. The problem is the way they are doing it. There has never been any information given about how much medication House actually needs to manage his pain. There has never been any indication that he went to see a pain-management-specialist. There has never, as far as I recall, been any acknowlegement that even if his pain is worsened by psychological issues, or by just havng a bad day/ week/ month, it is still real pain that he needs to deal with somehow. In his case, maybe that pain is so horrible that medication is the only way? I hate the common misconception that psycho-somatic means “all in your head” when really, it means that your psyche can influence your body. And I hate the generalisation that, if one pain is psycho-somatic, all pain is. Because that is just not true.

Yes, being unhappy about your live can make your pain worse. And yes, taking measures, if possible, to be happier about your life may make the pain lessen,or easier to tolerate. But it will not make the entirely physical root cause of the pain disappear. It will not magically “cure” you. And if there is no psycho-somatic element to your pain, it won’t change the pain at all.

No matter how much “therapy” they give House,his muscle will not magically grow back. No matter how “happy” he is, he will always need to manage his pain.

Oh and also? He is just one person. Stop acting as if, what is true for one person has to be true for everyone. Stop assuming that, because there might be psycho-somatic aspects to hi pain, the same is true for everybody with chronic pain. Stop pretending that you know anything about pain-killer dependence because you saw one (bad) representation of it on TV.

Thanks for the correction. I knew it was something that had made me just say, “What? He can manage his pain with just that? Then what have the previous five seasons been about?” but I couldn’t remember which drug it was.

I’m a big fan of the show, despite its massive problematic nature…but I’ve not a ton to contribute as I’m really not sure where my feelings lie and I don’t want to speak too much about things I only understand secondhand.

But another point of contention to bring up: House was shot at the end of S2, and as part of the treatment and recovery process in S3, he temporarily had no pain whatsoever before it slowly came back. This sort of adds to the ‘it’s all in his head’ bit, and brings up a lot of issues with TABness and ‘recovery’, in my mind. If others would want to speak to the nature of that, I thought it might be an interesting, if not current in the series, point.

I love House too and this has been frustrating me for AGES, THANK YOU. I absolutely cannot believe that an amount of ibuprofen which could control that amount of pain even exits, or if it does that it would be desirable to take long term. Ibuprofen is what I take when I get a headache because I forgot to wear my glasses for a couple of hours! That is not what House is going through!

I hate how they make all of House’s disabilities about the cane too, like there must be some physical, visible signifier of his difference. Because House, cane or no cane, is also mentally ill. They touched on this in the first few episodes of season 6 with his therapist, and they have had Cuddy and Wilson make reference to his depression (interesting incidence of art imitating life there, since Hugh Laurie has been remarkably open about his own depression), but it always seems to come back to how sad he is that he has a disability, which must be the worst thing EVAR. I recognize that chronic pain is a damned good reason to be irritable or unhappy, but the fact that they feel the need to reduce such a huge part of his life and self to his visible disability is problematic.

Alternately there’s a “medication will solve everything” mindset. As in, you’re mentally ill? Just take meds (never mind the compatibility, cost, side effects, time to adjust) and don’t bother me about it!

It strikes me as all part and parcel of TAB/CAB folks projecting their experience of medication onto PWD. For them, medication is something that gets you (general “you”) back to being “okay” – that is having a normatively abled body – where you were before. PWD have the experience of having a different default setting, for lack of a better term (start point? no. natural? ugh) so medication makes our lives easier than they would be otherwise. The need for medication is temporary for TABs, not so much for PWD. Hence “just take your pills, but then get the hell over it.” It’s not an excuse for ableism, because it’s still ableist, but I don’t think they’re necessarily incompatible within the TAB mindset.
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I am having a terrible time watching this season. They show him moving around in the same fashion as he was while on vicodin and this suggests that his pain was not all that great to begin with. It supports the idea that chronic pain patients need to just suck it up and this is dangerous in a world when we are often treated as drug seekers for wanting relief. Unless you have lived with chronic pain you cannot possibly understand what you are asking a person to live with. Due to the war on drugs we have this idea that drugs are wrong and I want to know why people don’t understand that this effects quality of life. The very same bravery that they demand in others they could not summon themselves.
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House is a great show. My wife and I have been watching it since the first season. Finding out that Greg had a pain problem really hit home with me. I had a TBI (Traumatic Brain Injury) several years ago which left me disabled with numerous problems, one of which is chronic head and neck pain. So I can totally relate to House’s pain issues. I’m not going to go into, or address, the comments above. It would just take too long. I just wondered if anyone noticed that House, a true genius at solving problems, has not followed the generally accepted pharmacologically correct management of pain. Meaning….you take a long acting medication to keep a steady state of opioid in your bloodstream and then use a short acting medication like Vicodin for breakthrough pain. As far as I know this is how most chronic pain patients deal with the daily agony they face. At least this is how John’s Hopkins, Georgetown University, Emory University and several neurologist and pain management doctors have dealt with my pain (at least the good doctors). The use of short acting medication is vital in pain management. I actually like to take short acting medication as soon as I can when I feel the pain coming. But to use it as the only opioid medication in your pain management plan just does not fit the current thinking in chronic pain treatment. The producers of House should look into getting Greg on a more suitable story line other than Vicodin to insanity to ibuprofen.

Bene: Supposedly after he was shot he had surgery where he was given a high dose of ketamine (I thought that was a horse tranquilizer? Good thing I’m not a doctor!), and the logic was that it resets his nervous system or something, so that there was some chance that he would be pain free, but also that it wouldn’t work.

I went for a long time where I was only treated for my “psychosomatic pain”, because of some military paperwork bullshit, and I could just spit blood it makes me so angry every time someone suggests that I am in pain because I am depressed, or that I should just ‘suck it up’. I freely admit that my pain worsens when I am under stress, because I can feel the tension, but that is part of the pain management program I went to speaking, where I learned to monitor the way I sit with my body and move and sit in ways that don’t add pressure…mental pain is real pain, and yes, I get angry that while everyone is busy telling House he should sober up and deal with his pain, but I am more angry that people are ignoring that he is already managing pain (to whatever degree of success apparently is debatable, but he is managing pain, even if the medicine is insulting).

I want to give a general warning: Just because pain management has been handled one way for you (general “you” here) specifically, even if it was by a nonillion doctors by all of the most prestigious schools and hospitals in the multiverse, that doesn’t mean that it is the standard of care for everyone. Not everyone can physically do the physio first, and not everyone can tolerate the long term meds w/ short term for break through. Every body is different, everbody is different, and I don’t want drive by medical judginess on one of my threads. Got it?

But another point of contention to bring up: House was shot at the end of S2, and as part of the treatment and recovery process in S3, he temporarily had no pain whatsoever before it slowly came back.

I’d forgotten that part, Bene.

Hmm.

Gunshot wounds hurt. TV (with vanishingly few exceptions) makes no attempt to portray them accurately. The recovery from them takes months, and is also painful. And unpleasant in other ways, which I’ll skip to spare our readers who are triggered by gore. Unfortunately I’m a primary source on this: at one point in my life when I was not dealing with depression to the point where I was having dissociative episodes and a lot of intrusive suicidal and self-harming idiation, I owned a .357 revolver. And I drank a lot. I got very, very, very lucky and have all my fingers and a left hand that mostly works. It’s also a barometer/hygrometer now, but so’s the rest of me.

Getting back to what to Tlönista said, post-shooting myself I did not get good mental health care though it seems kind of obvious now that it was the beginning of my path towards depressive psychosis. I got pills shoved at me and I vaguely remember someone trying CBT with the depression — which didn’t work for the same reasons treating my alcohol use as a primary disorder didn’t work.* They were symptoms. Trying to live as a wrong gender and a wrong sexuality have deleterious effects on the mind.

* It did annoy me immensely, especially AA’s** insistence that a) alcohol was the source of all problems (wanna bet?) and b) recovery was possible only through belief in and surrender to a higher power. “I’m an atheist. What am I supposed to do?”

“Ain’t no atheists at rock bottom.”

Muttered: “Fuck off.” Attendance was mandatory during my time in inpatient care.

** I know AA and its spinoffs into narcotics and gambling addictions help a lot of people and that’s fantastic but their approach could not have been worse for me personally. Surely there have to be other modalities of addiction treatment. (And screening processes that can differentiate primary alcoholism from secondary or tertiary alcohol abuse that would abate if the underlying conditions were treated. The assessment seemed designed to mark anyone who’d used alcohol as nearly everyone uses alcohol (there were lots of “Have you ever?” questions). No one at all wanted to help me with the core problems. Maybe ’cause they got paid for alcohol abusers but not for trans* folk?)

Ouyang Dan, I am not sure if you were replying to me, but in case you were: If Imade it sound in any way like the possible psychosomatic aspects of House’s pain justify the way he is portrayed by the show, Iam sorry. I think it is important to be aware of the ways that our bodies and minds interact- in ways that can be posittive or negative for s. But I absolutely hate it when people assume that focussing only onpossible psychological or emotional problems is the way-and the only way- to deal with pain.

I have gotten these “You just have to work on yourself” messages a couple of times over the course of my depression when I felt secure enough to admit to taking anti-depressants and found it absolutely infuriating. I can not even imagine how much worse it would be if I had to deal with pfysical pain on top of that.

Also, I think that the people who claim that one should be able to deal with whatever illnesses or impairments or problems one has no matter what are really just the flipside of those who seem to think that the way to solve any health-issue is to just “toss a pill at it”.After all, the first often use the latters attitude as a justification for their “better” approach when really, all of them are saying “I am unwilling to consider the myriad of aspects of your particlar situation, just as I am unwilling to acknowlege the fact that every human is an individual and that what works for one might not work for the other. So here s my universal solution. Now go away and stop bothering me.”

And even for people whose chronic pain does have a psychological element, it’s just wrong to suggest that a person can control it if they just bothered to try hard enough. My boyfriend has this–partially due to being overmedicated with psychiatric meds in the past–and this has taken a while for me to understand. It’s not as simple as trying hard or snapping out of it, and anyone who thinks that obviously has no experience with mental illness.
.-= Sarah´s last blog .."Glee" Fails in Representations =-.

Usually anything in pop-culture, especially network TV, dealing with addiction is going to screw things up six ways from Sunday. One common feature I’ve noticed on shows, news features, etc. is that “addict” is treated as a personality type, that all addicts are fundamentally the same. Yeah, not so much.

I am on an all-narcotic pain management plan because the other treatments didn’t pan out for me. I had some concerns about it – it’s quite a bit of narcotics – and my parents are both prescription addicts. One didn’t survive his addiction. Several years later, I’ve managed to not string myself out, so I certainly feel better about it. Now I just fret about acetaminophen.

It did annoy me immensely, especially AA’s insistence that a) alcohol was the source of all problems (wanna bet?) and b) recovery was possible only through belief in and surrender to a higher power.

“I’m an atheist. What am I supposed to do?”

“Ain’t no atheists at rock bottom.”

Muttered: “Fuck off.” Attendance was mandatory during my time in inpatient care.

This has bothered me, too. I haven’t ever been in a position to need a recovery program, but my entire immediate family is atheists and it has occurred to me that most of these 12-step drug and alcohol rehab programs would exclude us.

(Also, I loathe rhetoric of the “no atheists in foxholes/at rock bottom/in any extreme situations. It implies that my atheism is an affectation and a luxury, rather than just what I believe. That kind of dismissive talk probably strengthens my resolve to stay an atheist more than anything: “Oh yeah? I’ll show you!!“)

There *IS* one secular 12-step program I can think of, called Rational Recovery. That would at least get rid of the “higher power” problem, but probably not do much about the other problems you mention, like not bothering to address any of the underlying problems that might lead a person to self-medicate with alcohol or drugs…
.-= Lindsay´s last blog ..How *NOT* to Do Superhero Halloween Costumes =-.

reminds me of an episode early on in grey’s anatomy. i think it’s mcdreamy and alex, dealing with a guy who’s trying to get a fix of oxycodone or something. alex refuses to prescribe it and something bad happens. derek chastises him, saying basically what you said. “yes, he’s addicted. yes, he’s gaming the system. but he also has real pain that we need to treat before we can even begin to treat the other issues.”
.-= InfamousQBert´s last blog ..I have a problem =-.

kaninchenzero – thank you for making the points about addiction sometimes being a symptom of something else. A family member of mine was treated for substance addiction when he was younger, but now he can partake in the occasional substance – because what he found out as his journey continued was that he was abusing substances to treat his rage problems and once he got those under control, he no longer had an issue with the substances. When he first “came out” to me that he does sometimes now have a drink, I was really worried because the only model I knew of for recovering was AA-style, which says once you have a substance addiction you never EVER use any addictive substance again. I was worried he was in denial, was going to slip, etc. But it’s been many years, and he continues to have his rage issues well under control and as far as I know – has no issues with addiction anymore. It took me a long time to suss out that his method of doing things was okay, because it worked For Him.

But back to the original topic – actually, I go off the rails a bit and since I don’t watch the show and am not commenting critically about it/the post itself and just my views on the general topic of pain management, I made my own post about it … linked to with the commentluv.
.-= Rosemary´s last blog ..Chronic pain management is not addiction =-.

Lauren: Nope, not replying to you specically. There were a few comments on this thread that I felt were treading on the grounds of “this is how pain management is supposed to work”, and I that doesn’t swing on my playground. I just want everyone to remember that different people go through different programs that work. A fully mental health and physical therapy regimen did exactly ZERO for me (and did actual physical and mental harm), but I know that it has worked for others. Also, there is no way that some people, myself included, could do the full physio work up that sometimes comes w/ opiate regimens, such as treadmill or swimming workouts. There is no “standard” when it comes to these things. Only what works between a patient and hir doctor.

IQB: I liked the way that was done in that episode too. I am actually impressed with the way they handle some hot topics where other show really hit the FAIL, and deeply disappointed with the way they handle others (see: everone’s reaction to George joining the Army). I am actually doing some research to do a post on Owen and his PTSD right now.

Ouyang Dan: Thanks for answering my questions 🙂 I think it clicked for me when someone else mentioned “dependency” being different than “addiction.” And I apologize for being unclear (about House being “in control” of his addiction); I used the wrong terminology because I’m not used to talking about these things. This comment thread has been interesting and enlightening.

Kaninchenzero: AA does do a lot of good things and helps lots of people, but I also hate the religious aspect of it (and I’m a Christian). They also have a slew of other problems, but I’m not going to bore you with them…
It also sounds like you were in a bad group/chapter. From the little I know, AA does (or should) recognize multiple addictions and the importance of finding the primary addiction and addressing those problems, but you were probably in a group that deal with alcoholism only (or had only had to deal with that up until then) and the sponsors/leaders didn’t know how to handle your situation (or were too lazy to help you find the help you needed).
.-= Criss´s last blog ..Dear Biblethumpers: You’re doing it wrong. And making the rest of us look bad. =-.

Not all AA/12-step groups are that hung up on the G-word. It really varies a lot; through my involvement in other programs in the past, I was told there are indeed AA meetings for atheists (mainly in larger cities). (Twelve-step meetings also have the option of degenderizing references to God, by group conscience. And you’re always allowed to not read or say anything aloud that you don’t care for; any group that doesn’t allow that is in violation of the 12 Traditions.) Atheists and agnostics attending the less Christian-oriented meetings are told they can make the AA group their higher power, nature, whatever, and that “higher power” of one’s understanding need not equate to “string puller sitting on a cloud,” it can just mean “source of greater wisdom.” So Buddha counts, too. But it is kind of crappy that more people aren’t being given more of a choice.
.-= Meowser´s last blog ..Well, I Dood It =-.

I’m a bit late commenting; I hope nobody minds, but I found this discussion really fascinating and am only now catching up with all my bookmarks after a few days away from the internet.

Two points I particularly agree with:

1. The idea that House’s pain management issue is treated as a negative thing by other characters in part because he doesn’t hide it. I think this is a really key thing. The socially accepted narrative of disability is that disabled people bravely soldier on, because that’s what good disabled people do. If you’re in pain, you grin and bear it, even if you feel like your spine/leg/bowel is being eaten by crocodiles. Whereas House constantly draws people’s attention to his pain; he doesn’t allow them to forget that it’s a factor in his daily life. And we’re kind of not supposed to do that. It’s seen as distasteful to ‘make a show’ of chronic pain or other factors of disability, even though someone else making constant references to some other complicating factor in their life would just be seen as normal.

2. The possibility of a psychosomatic dimension to House’s pain being treated badly. This is really concerning. I think that some types of pain get a lot harder to deal with if you’re going through other bad stuff, be it physical, mental, emotional or circumstantial. And there are sometimes forms of distraction that can work on some types of pain for some people.

The problem comes in when this is all judged on a moral scale, with the person experiencing pain treated as lesser, morally, if they can’t manage to ‘rise above it’ or ‘push through it’ . And then there’s the issue of precedent: that if someone manages to cope *despite* their pain once, or in one situation, it is assumed by those around them that they can and should do so in every situation and at every occurence.

Honestly, if we could uncouple disability issues from moral judgments in people’s minds, it would make life a hell of a lot easier…
.-= Ang´s last blog ..The ‘hello’ post. =-.